title: Sexual dysfunction during treatment with serotonergic and noradrenergic antidepressants: clinical description and the role of the 5-HTTLPR.
abstract: OBJECTIVE
  Sexual dysfunction (SD) is a frequently reported side-effect of antidepressant treatment, particularly of selective serotonin reuptake inhibitors (SSRIs). In the multicentre clinical and pharmacogenetic GENDEP study (Genome-based Therapeutic Drugs for Depression), the effect of the serotonin transporter gene promoter polymorphism 5-HTTLPR on sexual function was investigated during treatment with escitalopram (SSRI) and nortriptyline (tricyclic antidepressant).
  
  
  METHODS
  A total of 494 subjects with an episode of DSM-IV major depression were randomly assigned to treatment with escitalopram or nortriptyline. Over 12 weeks, depressive symptoms and SD were measured weekly with the Montgomery-Asberg Depression Rating Scale, the Antidepressant Side-Effect Checklist, the UKU Side Effect Rating Scale, and the Sexual Functioning Questionnaire.
  
  
  RESULTS
  The incidence of reported SD after 12 weeks of treatment was relatively low, and did not differ significantly between antidepressants (14.9% escitalopram, 19.7% nortriptyline). There was no significant interaction between the 5-HTTLPR and antidepressant on SD. Improvement in depressive symptoms and younger age were both associated with lower SD. The effect of age on SD may have been moderated by the 5-HTTLPR.
  
  
  CONCLUSIONS
  In GENDEP, rates of reported SD during treatment were lower than those described in previous reports. There was no apparent effect of the 5-HTTLPR on the observed decline in SD.
authors.affiliation: Central Institute of Mental Health, Division of Genetic Epidemiology in Psychiatry, Mannheim, Germany. jana.strohmaier@zi-mannheim.de
authors.forename: Jana
authors.initials: J
authors.lastname: Strohmaier
authors.forename: Stefan
authors.initials: S
authors.lastname: Wüst
authors.forename: Rudolf
authors.initials: R
authors.lastname: Uher
authors.forename: Neven
authors.initials: N
authors.lastname: Henigsberg
authors.forename: Ole
authors.initials: O
authors.lastname: Mors
authors.forename: Joanna
authors.initials: J
authors.lastname: Hauser
authors.forename: Daniel
authors.initials: D
authors.lastname: Souery
authors.forename: Astrid
authors.initials: A
authors.lastname: Zobel
authors.forename: Mojca Z
authors.initials: MZ
authors.lastname: Dernovsek
authors.forename: Fabian
authors.initials: F
authors.lastname: Streit
authors.forename: Christine
authors.initials: C
authors.lastname: Schmäl
authors.forename: Dejan
authors.initials: D
authors.lastname: Kozel
authors.forename: Anna
authors.initials: A
authors.lastname: Placentino
authors.forename: Anne
authors.initials: A
authors.lastname: Farmer
authors.forename: Peter
authors.initials: P
authors.lastname: McGuffin
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Aitchison
authors.forename: Marcella
authors.initials: M
authors.lastname: Rietschel
mesh_terms: D018759:Adrenergic Uptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D000483:Alleles; D015283:Citalopram / Q000008:administration & dosage / Q000009:adverse effects*; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000235:genetics / Q000378:metabolism; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D009661:Nortriptyline / Q000008:administration & dosage / Q000009:adverse effects*; D010597:Pharmacogenetics / Q000379:methods; D011401:Promoter Regions, Genetic / Q000187:drug effects / Q000235:genetics; D011569:Psychiatric Status Rating Scales; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics / Q000502:physiology*; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced* / Q000235:genetics / Q000378:metabolism
chemical_list: D018759:Adrenergic Uptake Inhibitors; D015283:Citalopram; D009661:Nortriptyline; D050486:Serotonin Plasma Membrane Transport Proteins; D017367:Selective Serotonin Reuptake Inhibitors; C493230:SLC6A4 protein, human